Looking at HIV and Aging with Dr. Perry Halkitis

Imagine a death sentence, suddenly lifted. With the advent of antiretroviral therapy in 1996, that happened for the men who had been sure that they would die of AIDS. Now, decades later, this group of men is facing the unknown challenges of aging while HIV-positive.

The Centers for Disease Control estimates that by 2015 over half of the HIV-positive population in the United States will be 50 years old or older. Although medical understanding of the disease has grown substantially over the years, knowing how to handle an aging HIV-positive population is still uncharted territory.

Neither the disease nor this aging population is outdated or irrelevant. The stories of the men who lived through the beginning of AIDS in the 1980s are a powerful conduit to the past. These stories teach us how to survive the unknown, how to keep going against the odds, and how to find the strength to adapt to change and to live life fully.

Dr. Perry Halkitis, Professor of Applied Psychology, Public Health and Medicine at NYU Steinhardt, is dedicated to keeping the community connected to these stories. In his book, "The AIDS Generation: Stories of Survival and Resilience," he tells of 15 survivors, all diagnosed HIV-positive between 1984 and 1993. Published by Oxford, the book is due to be released this fall.

"I wanted to make sure our stories were told lest they be forgotten. I wanted our experiences and what we lived through -- everybody, positive or negative -- to serve as a role model for a younger generation," said Halkitis in a recent interview with EDGE. "The way my generation dealt with this disease serves as a model for anyone dealing with chronic illness."

Are HIV-positive People Aging Faster?

This is a story told by many different voices. Halkitis wanted to find a diverse group of men who could tell stories that explored how to accept the challenges of the disease and create a healthy life as an older man with HIV. These men come from all over the United States and continue to correspond with Halkitis and each other.

"You could say that people living with HIV focus on physical well-being," said Halkitis. "What these men also realized was that in addition to their physical health, they had to attend to their social and emotional well-being." That practice kept them going, even in the most dire of circumstances. It helps keep them going today, finding ways to face the challenges of aging while living with HIV.

Middle age is bringing multiple health concerns for HIV-positive people. Seemingly not directly related to the virus, these issues are usually seen in older populations. Clinicians aren’t sure why they’re showing up at a younger age than expected for this group of patients.

"We have to look at the role antiretrovirals play in the aging process," said Halkitis, "Not just the disease but also the medications." Older HIV-positive patients are showing higher rates of heart disease, cancer, lung disease and other chronic illnesses that usually don’t appear until later in life. Recognizing that there is insufficient information to evaluate the health needs of this population is a practical place to start.

While there is also a rise in the number of older people getting infected with HIV, this population is different. Having lived with the virus and the treatment for so long, often over 15 years, it’s possible that this group is experiencing accelerated aging.

"We know that if a body is bombarded by a virus, the body experiences inflammation," explains Halkitis. "People who were infected before 1996, who experience a greater impact from the virus, may have accelerated aging."

The Strength to Accept the Unknown

Resilience is strength combined with the ability to adapt. It is an essential quality for continuing to handle a disease that provides so many ongoing challenges. "We know very little about the needs of aging baby boomers, even less about those who are gay, and nearly nothing about those who are positive," states Halkitis. These men, now moving into the new frontier of aging and HIV, continue to pave the way for the community through their experiences and their stories.

"We’re starting to have a conversation about the community in support of this population," Halkitis said. Only just beginning, this conversation needs voices to grow; voices that tell stories about survival; voices that talk about the strategies that keep them moving forward; voices that tell us that the struggle with HIV is not over; voices from across the country and across the world.

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